Base unit calculations on the updated code definitions, or pay the price.
HCPCS codes for chemotherapy agents underwent a major overhaul for 2011, but those aren't the only code changes you need to know. Look below to see even more additions and deletions that could affect your coding.
Smart move:
Take extra care when calculating units for the new codes. For example, in 2010 a single unit on your claim of (now deleted) code J0560 (
Injection, penicillin G benzathine, up to 600,000 units) captured a dosage of 600,000 units. In 2011, the same dosage will require you to report 6 units of the new code J0561 (
Injection, penicillin G benzathine, 100,000 units). If you forget to report the additional units, you won't be reimbursed adequately.
Note:
HCPCS codes are available at
www.cms.gov/HCPCSReleaseCodeSets/ANHCPCS/list.asp. See
Oncology and Hematology Coding Alert, vol. 12, no. 12, "J9080-J9097 Head to the Chopping Block in 2011" and "J9302, J9307, and J9315 Offer New Options for Lymph Cancer Drugs" for more information on HCPCS changes in 2011.